Abstract
Background Post-enucleation socket syndrome (PESS: deep upper lid sulcus, ptosis or upper lid retraction, enophthalmos and lower lid laxity) is a well-recognised complication of a volume-deficient anophthalmic socket. A patient requiring enucleation following severe ocular trauma may have an underlying orbital wall blow-out fracture which if overlooked can cause severe volume deficit with poor cosmesis and limited prosthesis motility.
Purpose To establish the prevalence of an undiagnosed blow-out fracture in patients with PESS and a history of relevant trauma.
Methods Medical records and orbital computed tomography (CT) scans were reviewed for all patients presenting with PESS and a history of relevant trauma.
Results Undiagnosed blow-out fractures were found in 15 (33%) of 45 patients presenting between August 1993 and December 1996. These were significant enough to warrant surgical repair in 13 (29%) patients.
Conclusions We suggest that any patient presenting with PESS and a history of relevant trauma should be considered to have an orbital wall blow-out fracture until proven otherwise by CT scanning of the orbit. Similarly any patient requiring enucleation following severe ocular trauma should undergo CT scanning to rule out a coexisting blow-out fracture which could be repaired at the time of enucleation.
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Ataullah, S., Whitehouse, R., Stelmach, M. et al. Missed orbital wall blow-out fracture as a cause of post-enucleation socket syndrome. Eye 13, 541–544 (1999). https://doi.org/10.1038/eye.1999.134
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DOI: https://doi.org/10.1038/eye.1999.134